Africa Knowledge Hub for Children

Peer-reviewed articlePubMed (US National Library of Medicine)20 Mar 2026

Parents' experiences with the Circle of Security Parenting (COSP) intervention - a scoping review of qualitative studies.

BACKGROUND: Research on the Circle of Security Parenting (COSP) program is limited. AIMS: The current study was performed to map and synthesize the existing qualitative literature on parents' experiences of participating in the COSP to address gaps in the current knowledge base. METHODS: A scoping review was carried out. Sixteen qualitative studies with samples from well-baby clinics, community health care, child welfare services, specialist mental health care services for children, and specialist mental health care for adults were included in this review. The sample included 172 informants, mostly women. RESULTS: Thematic content analysis found three main themes and eight sub-themes. Theme 1: Parents' journey of self-reflection, self-development, learning and understanding of the parenting role. Sub-theme: (1a) COSP as a source of increased self-understanding and security in the parenting role, (1b) emotionally demanding processes for parents. Theme 2: COSP, a source of changes in the child and parent‒child relationship and interaction with others. Sub-theme: (2a) COSP assessed as having a positive impact on the child. (2b) COSP assessed as improving parent‒child interaction. (2c) COSP as a source of conflict resolution. Theme 3: COSP is assessed as positive, yet sometimes adaptations are needed. Sub-theme: (3a) Parents experience the COSP as useful for their everyday lives and recommend the program to other parents. (3b) Parents have comments and suggestions regarding the implementation of the COSP. (3c) The COSP is recommended by parents outside the target group, but adaptations are required. CONCLUSIONS: The review shows that parents find the COSP intervention to have valuable potential as a health-promoting intervention, but the program should be used with careful consideration to non-target groups.

Peer-reviewed articlePubMed (US National Library of Medicine)21 Mar 2026

How to increase participation and compliance in a national, school-based survey: strategies from the HBSC study 2018, 2022 and 2024 in Kalaallit Nunaat.

The Health Behaviour in School-aged Children (HBSC) study has an important role in monitoring health and well-being among children and adolescents in Kalaallit Nunaat (Greenland), and the results are continuously used to inform and direct public health policies in Kalaallit Nunaat. However, the study has faced challenges in ensuring sufficient school-based participation and individual-level compliance, potentially diminishing the representativeness and validity of the study results. We examined how variations in data collection and survey strategies across waves of data collection in 2018, 2022 and 2024 may have influenced participation and compliance rates by comparing differences observed across the three waves. We found that secondary onsite support, targeted follow-ups, scheduling dates for data collection, supporting school engagement and leveraging local authority networks were effectful in increasing school-based participation. Compliance was significantly associated with the survey administration mode and was likely related to school engagement. Respondent fatigue remained a barrier for sufficient compliance; however, electronic, revisitable survey administration has mitigated this challenge. This study concludes that applying meaningful strategies during recruitment and data collection has real potential to increase school-based participation and compliance and underscores the importance of nesting the study within the local context, community and relations.

Mie Mølgaard Andersen, Kirsten Nystrup, Durita Lyngsø Svartá et al.

DevelopmentParticipationGLRead at source

Peer-reviewed articlePubMed (US National Library of Medicine)27 Mar 2026

Interventions to support young carers/supporters of people living with dementia: a mixed methods systematic review.

PURPOSE: Despite children being young carers for people living with dementia globally, and evidence suggesting they need more support, there is limited research evaluating best practice for dementia-care related interventions for children. The purpose of this work was therefore to comprehensively summarise the existing literature by synthesising studies appraising existing child-focused and dementia-care relevant interventions. METHOD: A mixed methods systematic review with a convergent integrated synthesis approach. Four databases were systematically searched from 1st January 2013 to 9th February 2024. Qualitative, quantitative, and mixed methods studies evaluating any intervention programme that aimed to improve children's understanding and/or support for people living with dementia were included. RESULTS: Seventeen studies, evaluating 15 different interventions (1,345 participants), were eligible for inclusion. Extracted data were inductively synthesised into 18 categories, forming six integrated findings relating to what makes interventions useful for helping children to understand and/or support people living with dementia. CONCLUSIONS: The findings can inform the development of interventions for children with dementia care responsibilities, and further robust research.

Kirstie Goodchild, Ellice Parkinson, Jane L Cross

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Peer-reviewed articlePubMed (US National Library of Medicine)1 Apr 2026

The association between serum trace elements and iron deficiency anemia in children and adolescents: a systematic review and meta-analysis.

OBJECTIVES: Iron deficiency anemia (IDA) remains the most prevalent form of anemia in children and adolescents globally. In addition to iron (Fe), other trace elements, such as zinc (Zn), copper (Cu), and magnesium (Mg), may influence hematopoiesis, yet the extent of their dysregulation in IDA remains unclear. METHODS: We conducted a systematic review and meta-analysis of observational studies assessing the serum levels of Fe, Zn, Cu, and Mg in pediatric IDA populations. The literature was searched in PubMed, Scopus, Embase, and Web of Science up to January 2025. The data were standardized to consistent units (μmol/L), and pooled weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Subgroup, sensitivity, and publication bias analyses were performed. The study protocol was registered online (PROSPERO number: CRD42024578704). RESULTS: Eight articles encompassing twelve datasets and 1105 participants were included. Compared to controls, IDA patients had significantly lower levels of Fe (WMD: -13.07 μmol/L, 95% CI: -16.09 to -10.05), Zn (WMD: -4.33 μmol/L, 95% CI: -5.30 to -3.35), and Mg (WMD: -18.17 μmol/L, 95% CI: -21.00 to -15.33) but higher levels of Cu (WMD: 4.33 μmol/L, 95% CI: 2.21-6.46). High heterogeneity (I² > 95%) was noted for Fe, Zn, and Cu. Subgroup analyses confirmed consistent trends across age, gender, and geography. CONCLUSION: Pediatric IDA is associated with broad alterations in trace elements, highlighting potential roles for Fe, Zn, Cu, and Mg in the pathophysiology of anemia. These findings may inform comprehensive nutritional strategies in managing IDA.

Maryam Mobasheri-Shiri, Sepehr Ramezanipour, Zahra Azizi et al.

SurvivalRead at source

Peer-reviewed articlePubMed (US National Library of Medicine)6 Apr 2026

"Sometimes it's the bullying": an exploratory qualitative study of church leaders' perceptions of dietary health of black American children and youth.

PURPOSE: Childhood obesity rates continue to increase, especially for Black Americans. Few church-based health interventions have focused on children and youth. The purpose of this exploratory qualitative study was to determine church leaders' perceptions of the dietary health of children and youth. METHOD: As a follow-up study to the Health for Hearts United Dissemination Trial, a focus group was conducted with one of the participating churches in North Florida that had identified child dietary health as a priority. Five adults and three youth (n = 8) participated, guided by four questions. The focus group was recorded, transcribed and analyzed using thematic analysis. RESULTS: Three major categories, five themes and six subthemes were identified. The categories included cultural background, motivators and barriers, and potential dietary initiatives. Themes and subthemes included learned behaviour (commitment and habits), family history, motivating factors (role models), challenging factors (parent involvement, bullying, consistency), and interventions (programs and practices). CONCLUSIONS: The findings suggest that improving the health of children within the church context is complex. The participants identified several barriers, but also identified motivating factors and were enthusiastic about possible church programs and practices to improve the dietary health of children.

Laura O Howard, Penny A Ralston

SurvivalDevelopmentUSRead at source

Peer-reviewed articlePubMed (US National Library of Medicine)8 Apr 2026

Power, surveillance, and the limits of resistance: The role of community health workers in India's health system.

Accredited Social Health Activist (ASHA) workers, India's community health workers (CHWs), serve as the primary link between households and the health system. They perform essential maternal and child health tasks while absorbing administrative and programmatic responsibilities. However, research on ASHAs and CHWs remains fragmented, often siloed into separate discussions of labor conditions, workplace hierarchies, and surveillance. This paper integrates these perspectives to examine how health systems rely on low-cost, flexible labor to sustain themselves. Drawing on ethnographic fieldwork in India, including participant observation and in-depth interviews, this analysis shows that ASHAs' constrained autonomy is not only the result of systemic inefficiencies, but is shaped by governance arrangements that produce and reinforce disempowerment. Findings reveal that hierarchical task delegation, economic precarity, and routine surveillance work in tandem to constrain autonomy among ASHAs. These conditions limit their capacity to resist expanding responsibilities, while simultaneously enabling the health system to function without structural reform. This analysis offers conceptual tools for understanding how informal health labor is governed, disciplined, and constrained across CHW programs in low- and middle-income countries.

Baldeep K Dhaliwal

INRead at source

Peer-reviewed articlePubMed (US National Library of Medicine)16 Apr 2026

Microbiome signatures correlate with diet-mediated ADHD symptom reduction.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood neuropsychiatric conditions. Both (epi)genetic and environmental factors are suggested to contribute to the etiology of ADHD. In the last decade, nutrition has received considerable attention as a potential environmental factor triggering ADHD behavior, particularly applying a few-foods diet (FFD) has been shown to elicit considerable behavioral improvements. These studies are observational rather than investigating underlying molecular mechanisms. The present study included 79 children (boys aged 8-10) with ADHD following a progressive, i.e., increasingly restrictive, FFD diet for 5 weeks. Minimally invasive samples (feces, urine, blood, and buccal swabs) were collected before and after the intervention to obtain a multi-omics perspective of the dietary responses in the participating children. For 63% of the participating children, a more than 40% behavior score improvement was observed, with an average improvement of 73%. The strength of diet-induced changes in ADHD symptoms among children was significantly associated with the gut microbiome composition, particularly when analyzing species-stratified abundance profiles of previously characterized gut-brain modules in the fecal metagenomic data. While integrative multi-omics analysis did not identify composite signatures linked to symptom changes, the strongest multi-omics signal confirmed compliance with the dietary intervention. Our findings implicate a role of the gut microbiome and its metabolic capacity to communicate with the central nervous system in children with food-associated ADHD.

Saartje Hontelez, Martin Guthrie, Tim Stobernack et al.

DevelopmentSurvivalPre/postRead at source

Peer-reviewed articlePubMed (US National Library of Medicine)25 Apr 2026

The effect of the healthy lifestyle 'empowerment program' on care burden and adherence to health-promoting behaviours on mothers of children with type 1 diabetes.

Mothers caring for children with type 1 diabetes (T1D) face significant care burdens requiring effective interventions. This study evaluated the impact of a Healthy Lifestyle Empowerment Program (HLEP) on care burden and adherence to health-promoting behaviours in these mothers. In this experimental study in Tehran (2024), 64 mothers of children with T1D were randomly assigned to the intervention (n = 32) and control (n = 32) groups. The intervention group participated in four weekly 45-60-min educational sessions focusing on health-promoting behaviours. Data were collected using the Caregiver Burden Index (CBI) and Health-Promoting Lifestyle Profile II (HPLP-II) at baseline, immediately after and 12 weeks post-intervention. Data were analysed using SPSS v.18. The intervention group showed a significant reduction in care burden immediately and 12 weeks after HLEP (p = 0.311), while their health-promoting behaviours improved significantly over time (p = 0.027). Conversely, the control group experienced increased care burden (p = 0.000) and decreased health-promoting behaviours (p = 0.017). HLEP effectively reduced the care burden and enhanced health-promoting behaviours among mothers of children with T1D. The incorporation of such empowerment programs into healthcare services is recommended to support caregivers managing chronic illnesses.

Behnaz Farahmandfard, Abolfazl Rahgoi, Mohammad Saatchi et al.

SurvivalDevelopmentExperimentalIRRead at source

Peer-reviewed articlePubMed (US National Library of Medicine)9 May 2026

The prognostic value of AQP1 in hyperbilirubinemia related to ABO hemolytic disease of the newborn.

BACKGROUND: ABO hemolytic disease of the newborn (ABO-HDN) is a major cause of hyperbilirubinemia in neonates, often inducing significant elevation of serum bilirubin levels shortly after birth. PURPOSE: This study aimed to assess the prognostic value of Aquaporin 1 (AQP1) for hyperbilirubinemia in ABO-HDN as reflected by the duration of phototherapy, a key clinical indicator of disease severity and treatment response. METHODS: A retrospective cohort study was conducted, enrolling 168 neonates with ABO-HDN-related hyperbilirubinemia. Serum AQP1 expression was detected by RT-qPCR, and neonates were divided into a high-AQP1 expression group (n = 84) and a low-AQP1 expression group (n = 84) according to the median. All neonates were followed up for 7 days after the initiation of phototherapy, and a cure was defined as no total bilirubin (TBIL) rebound within 48 h after reaching the normal TBIL level. The cure rate was defined as the proportion of participants who achieved a cure within the 7‑day follow‑up period. RESULTS: The AQP1 expression in the ABO-HDN group was significantly higher than that in the control group. Additionally, the high-AQP1 group had a longer cure time and a lower cure rate within 7 days. Spearman analysis showed that AQP1 was positively correlated with TBIL (R = 0.481, P < 0.001). Cox regression analysis confirmed that high AQP1 expression was associated with a reduced cure rate (HR = 0.623, 95%CI: 0.449-0.861, P = 0.004). CONCLUSION: High-AQP1 expression was closely associated with prolonged treatment duration in ABO-HDN-related hyperbilirubinemia. AQP1 can serve as a potential molecular marker for prognostic assessment and individualized treatment guidance in such neonates.

Zhenzhen Liu, Wei Shi, Jian Zhu et al.

SurvivalPre/postRead at source

Peer-reviewed articlePubMed (US National Library of Medicine)11 May 2026

From emergency relief to system strengthening: Stakeholder perspectives on official development assistance for reproductive, maternal, neonatal and child health in Guinea-Bissau.

Guinea-Bissau, a politically fragile West African nation, relies heavily on official development assistance (ODA) to sustain reproductive, maternal, neonatal and child health (RMNCH) services. This study explored how national and international stakeholders perceive the role, evolution and effectiveness of RMNCH-related ODA and how these perspectives compare with donor strategies. We conducted semi-structured interviews with 10 key informants and applied an AI-assisted, systematically validated framework to analyse 50 donor documents, integrating findings through comparative coding and convergence-divergence synthesis. Stakeholders viewed ODA as 'humanitarian' or 'emergency' aid, substituting for the state rather than catalysing durable system change. Donor documents strongly emphasised coordination, alignment and ownership but tended to underplay political risk and institutional capacity limits. Triangulated analysis identified interlinked constraints: political instability and ministerial turnover, fragmented coordination despite multiple formal mechanisms, performative alignment with national plans, limited domestic financial contribution and an evolution toward vertical funding that risks further fragmentation. Findings point to the need for hybrid coordination arrangements combining national and international leadership, depoliticised and stable technical capacity within the Ministry of Public Health, longer and more flexible programme cycles with contingency mechanisms, and greater domestic financing and use of national strategic plans as a genuine framework for system strengthening.

Anaxore Casimiro, Réka Maulide Cane, Michel Jareski Andrade et al.

SurvivalDevelopmentGWRead at source

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